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MILDRED BLACKWELL

Adult Care Home

Elon, North Carolina

Provider NPI: 1164542882

Organization Information:
Organization Name:  MILDRED BLACKWELL


Practice Location:
3658 CHERRY GROVE RD  ELON, NC 27244 US
Tel: 336-421-0646  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y311ZA0620XNursing & Custodial Care Facilities
Custodial Care Facility
Adult Care Home
NCHAL017003

Other Provider Identifiers:

IssuerNumberStateType
7801723NC05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




ADULT CARE JOBS NC - Page 1